Palliative Care Alliance (PCA) is a healthcare solution that specializes in identifying patient risk level for readmissions, supporting discharge management processes, and providing patient management through transitional care.
Using experienced, clinical personnel, we have demonstrated significant patient satisfaction by providing:
Services provided to patients at home include a physician, nurse and medical social worker. Together the team develops a plan of care to address the symptoms related to the patient’s acute or chronic illness. The patient will be seen in the home setting with as many visits that are considered appropriate based on the customized plan of care. Additional resources and specialty services can be offered in order to keep a patient in their residence, thereby avoiding re-hospitalization.
The primary objective in providing transitional services to seriously or chronically ill patients is to reduce unwarranted hospital readmissions while providing and maintaining quality healthcare. To accomplish this, identified ‘High-Risk’ Patients will be evaluated and managed by the PCA interdisciplinary team to:
The PCA transitional care service integrates patient discharge and post discharge care through consistent and timely visitation by an expert clinical team in the residential setting. This is achieved while maintaining exceptional patient care and leveraging the existing strengths of the hospital and their staff. The steps toward PCA implementation during hospital stay and post hospital admission include: